Home
|
About the journal
|
Editorial board
|
Search
|
Ahead of print
|
Current issue
|
Archives
Subscribe
|
Submit article
|
Instructions
|
Subscribe
|
Contact us
|
Reader Login
Users Online: 455
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
Citation statistics : Table of Contents
2012| January-March | Volume 2 | Issue 1
Online since
December 3, 2012
Archives
Next Issue
Most popular articles
Most cited articles
Show all abstracts
Show selected abstracts
Export selected to
Cited
Viewed
PDF
ORIGINAL ARTICLES
Clinical profile and outcome of leptospirosis at tertiary care centre in western Maharashtra
Virendra C Patil, Harsha V Patil, Vaibhav Agrawal
January-March 2012, 2(1):30-37
DOI
:10.4103/2249-4855.104013
Background:
Leptospirosis is an emerging spirochetal zoonosis world wide. Leptospirosis is common zoonosis that is under reported and under diagnosed in India. The aim of this study was to study the clinical profile outcome and prognostic factors in human leptospirosis at tertiary care centre.
Settings and Design:
This was a retrospective study of leptospira positive patients who were admitted in tertiary care centre. The study was conducted in 2010, over a period of 6 month from July to December.
Materials and Methods:
All patients who presented with clinical features and tested IgM positive for leptospirosis were taken into the study and analyzed based on modified Faine's criteria.
Results:
Out of total 23 patients there were 21 males and 2 females, with mean age was 32 years. Maximum incidence of cases was found in month of July and August. Out of total 23 patients, 18 (78.26%) were farmers and 5 (21.73%) were laborers. Predominant complaints were fever, jaundice, myalgia, and headache. All 23 had positive results for IgM against leptospira. Liver function tests were deranged in 16 (69.56%) and renal functions were deranged in 12 (52.17%). Total 7 (30.43%) patients had Weil's syndrome and 7 (30.43%) had acute respiratory distress syndrome (ARDS). Total 7 (30.43%) patients had neuroleptospirosis, out of which 5 (21.73%) had aseptic meningitis, one had paraparesis secondary to lumbar radiculopathy and one had meningoencephalitis. Hyperkalemia was present in 6 (26.08%) patients, 7 (30.43%) patients had hypokalemia. Total 11 (47.82%) patients had metabolic acidosis (pH<7.3) on arterial blood gas analysis. Two (8.69%) patients had disseminated intravascular coagulation and 3 (13.04%) patients had thrombocytopenia. There was one death due to meningoencephalitis with multiorgan failure with overall case fatality rate of 4.34%. Total nine patients with oliguric renal failure were treated with daily dialysis and seven patients with ARDS were on artificial ventilator. Applying modified Faine's criteria, all 23 were positive for leptospirosis. All patients responded ceftriaxone.
Conclusions:
Leptospirosis was unexpectedly found to be positive in many of our patients who were having pyrexia with multiorgan dysfunction during the monsoons. Hepatic dysfunction, acute renal failure, ARDS, and neuroleptospirosis in decreasing frequency were the commonest complication. Daily dialysis, ventilatory support and intensive care management has definitely reduced morbidity and mortality associated with leptospirosis with multi-organ failure.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
6
7,000
804
Epidemiology of urinary tract infection in neonatal intensive care unit: A single center study in Egypt
Doaa Mohammed Youssef, Hanaa Abd Elfateh, Randa Sedeek, Sherif Seleem
January-March 2012, 2(1):25-29
DOI
:10.4103/2249-4855.104012
Introduction:
The aim of this study is to describe the epidemiology of urinary tract infection (UTI) in newborn infants admitted to neonatal intensive care unit (NICU) of Zagazig University.
Patients and Methods:
This study included 206 neonates admitted to the NICU in the period from 1/1/2010 to 1/6/2010. All neonates were subjected to detailed history taking, including prenatal history, natal history, and postnatal history, with stress on symptoms suggestive of UTI. We examined all neonates generally and locally, every case was subjected to urine analysis; suprapubic aspiration was done for all cases. "The diagnosis of UTI was established by the presence of at least 5 leukocytes per high power field." Urine culture, CBC (complete blood count), blood culture, and ultrasound scanning were also done for certain cases.
Results:
We found 75 newborns with clinical findings suggesting UTI. We classified our neonates according to the presence of at least 5 leukocytes in urine per high power field into two groups: Group I (−ve cases) without UTI included 44 neonates (31 males and 13 females) and Group II (+ve cases) with UTI included 31 neonates (24 males and 7 females). There was no significant difference between Group I and Group II with regard to gender, age, weight, and consanguinity. The incidence of UTI in NICU was 15.05% (33/206), prevalence among suspected cases of UTI in NICU was 41.3% (33/75), and of the 39 neonates with sepsis 33 had UTI (79.5%). Of the positive cases, 77.4% were full-term neonates and 22.6% were preterm neonates. Of the 31 cases with positive urinary culture there were 18 cases (58.1%) showing
Escherichia coli
, and 13 cases (41.9%) were positive for
Klebsiella
.
Conclusion:
This study has highlighted the need for routine urine analysis and culture, especially in high-risk newborns and to monitor the prevalence of UTI early in life. Also routine ultrasonographic screening should be done in all newborns with UTI to save the newborns and prevent the risk of complications, which may end in renal scarring and renal failure.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
4
7,810
668
Nephrotic syndrome in the first year of life
Manisha Sahay, Swarnalatha Gowrishankar, Girish Narayen, Anuradha
January-March 2012, 2(1):22-24
DOI
:10.4103/2249-4855.104011
Objective:
To study the clinical profile, laboratory data, histopathology, and outcome of infantile nephrotic syndrome (INS).
Materials and Methods:
Over a 5 year period, 30 infants with nephrotic syndrome were seen at Osmania General Hospital. They were studied with regard to family history, antenatal details, birth history, clinical features including anthropometry and developmental milestones, laboratory investigations and histopathology of renal tissue (light microscopy and immunofluorescence), and treatment outcome.
Results:
There were 17 males and 13 females (1:0.8). The mean age at presentation was 8.6 months (2.5-12 months). History of consanguinity was obtained in 12 infants (40%) and birth asphyxia was present in 8 infants (26%). Eighteen (60%) were growth retarded and 10 (33.3%) had developmental delay. Hypertension was recorded in 8 (26%) and edema in 24 (80%). At presentation, renal failure was evident in 18 (60%) infants. Nephrotic range proteinuria and hypoalbuminemia were found in all and microscopic hematuria in 4 (13%) infants. Histology of renal tissue revealed congenital Finnish type (CNF) in 8 (26%), diffuse mesangial sclerosis (DMS) in 6 (20%), minimal change disease (MCD) in 6 (20%), mesangial proliferation with IgM deposits in 4 (13%), and focal segmental glomerulosclerosis (FSGS) in 4 (13%). Mesangial hypercellularity with cytomegalovirus infection was found in 2 (6.6%) infants. CNF and DMS on histopathology carried a very poor prognosis with none recovering, while the others showed variable response to treatment with steroids and cytotoxic therapy.
Conclusion:
INS is a rare disorder. The predominant histopathological lesions are CNF and DMS which carry a very poor prognosis.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
2
4,881
646
CASE REPORTS
Gram-negative bacterial pyomyositis in a patient with diabetes mellitus and chronic renal failure
OP Kalra, Alpana Raizada
January-March 2012, 2(1):40-42
DOI
:10.4103/2249-4855.104015
Pyomyositis is a suppurative infection of the skeletal muscles. The predisposing conditions include immunosuppression accompanying malignancy, diabetes mellitus, renal failure, and acquired immunodeficiency syndrome, etc. We report a 49-year-old female with diabetes mellitus and chronic renal failure undergoing maintenance hemodialysis who presented with the suppurative stage of gram-negative bacterial pyomyositis due to
Escherichia coli
. She fully recovered following incision and drainage and appropriate antibiotic therapy. We highlight the importance of timely diagnosis of this uncommon and potentially life-threatening entity and the role of chronic renal failure and hemodialysis in causing this condition.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
1
4,755
392
Addiction to vitamin D: Unusual, unexpected substance abuse
Bharti Kalra, Yatan Pal Singh Balhara, Sanjay Kalra
January-March 2012, 2(1):43-45
DOI
:10.4103/2249-4855.104016
This case reviews the history and findings of a young patient with vitamin D deficiency, successfully treated with vitamin D, who became addicted to injectable calcitriol. To the best of our knowledge, this is the first report of such an occurrence in the world literature.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
1
7,637
509
REVIEW ARTICLES
Kidney and pregnancy
Manisha Sahay
January-March 2012, 2(1):15-21
DOI
:10.4103/2249-4855.104010
Pregnancy is associated with many physiological changes in the renal system. Pregnancy can alter the course of some renal diseases as also pre-existing renal diseases may affect pregnancy outcomes. Pregnancy may be complicated by hypertension which warrants proper management. Acute kidney injury may complicate pregnancy. With chronic kidney diseases on the rise, it is important for the physician to be aware of management of pregnancy in these patients. Kidney transplant recipients have their unique set of problems and management of these patients poses a challenge for the physician. Hence, this review highlights the management of pregnant patients with renal diseases including issues related to dialysis and transplantation.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
1
9,317
915
COMMENTARY
Leptospirosis: A case of "overdiagnosis" and "underdiagnosis"
Ramachandran Kasi Visweswaran, Melemadathil Sreelatha
January-March 2012, 2(1):38-39
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
3,490
371
EDITORIAL
Urinary tract infections in children: Consensus and controversies
Manisha Sahay
January-March 2012, 2(1):1-3
DOI
:10.4103/2249-4855.104008
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
10,031
783
LETTERS TO EDITOR
Detection of biofilm formation in bacteria from cases of urinary tract infections, septicemia, skin and soft tissue infections and post-operative infections by Congo Red Agar method
Anuradha De, Dhanashree Deshpande, Sujata M Baveja, Shripad Taklikar
January-March 2012, 2(1):46-47
DOI
:10.4103/2249-4855.104017
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
6,678
914
Dapagliflozin: A new drug for treatment of type 2 diabetes mellitus
Ameya A Hasamnis
January-March 2012, 2(1):47-48
DOI
:10.4103/2249-4855.104018
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
2,643
315
PICTORIAL CME
Girl with skin lesions over eye lids and ankles
H Radhakrishna, Ranga Lakshmi
January-March 2012, 2(1):49-50
DOI
:10.4103/2249-4855.104019
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
2,969
296
REVIEW ARTICLES
Pediatric obesity: A portent of the diseases to come
Rakesh Kumar Sahay, V Sri Nagesh, G Preeti
January-March 2012, 2(1):4-14
DOI
:10.4103/2249-4855.104009
Pediatric obesity is one of the most important health issues facing the world today. Changing lifestyles, affluence on the rise, introduction to new diets, changing social order and an increasingly sedentary lifestyle of the youth have contributed to the alarming rise of child and adolescent obesity. Recent definitions of obesity by WHO and IOTF have afforded distinct cutoffs to determine prevalence of obesity at the community level in children. Newer insights into leptin and its signaling pathways have helped our understanding of the genesis of obesity, which has been further bolstered by the numerous studies into the genetics of obesity. Endocrine disorders like hypothyroidism, Cushing's syndrome, and syndromic disorders need to be ruled out. In addition to the routine investigations, evaluation of markers of insulin resistance and fat percentage is of great research utility In Indian children, who differ metabolically from children in the west. The cornerstones of treatment are therapeutic lifestyle changes, behavior modification and pharmacological therapy when needed. However, primordial prevention by inculcation of a healthy lifestyle seems to be the best bet in combating pediatric obesity.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
9,818
781
Feedback
Subscribe
Sitemap
|
What's New
|
Feedback
|
Disclaimer
© Journal of Academy of Medical Sciences | Published by Wolters Kluwer -
Medknow
Online since 05 January, 2011